Jail suicide rate vexes California

Placement of mentally ill is critical problem in many states

LOS ANGELES — A record number of inmates in California's jails have committed suicide, state officials announced recently, drawing attention to what law-enforcement officers and experts say is a growing national problem: How to handle mentally ill people when they encounter the criminal justice system.

About 16 percent of the approximately 630,000 people in the nation's jails suffer from some form of mental illness, according to U.S. Department of Justice statistics, and experts say the way such inmates are handled varies widely across the country.

"There are huge differences in treatment between different jurisdictions," said David Finn, a Dallas lawyer and former judge who set up his own system for dealing with mentally ill individuals while on the bench. He said it was "in everyone's best interest to give these people the treatment they deserve and not just warehouse them, or put them on probation without helping them."

Not isolated incident

Finn cited the case of Rosa Guadalupe Alejo, 37, who was arrested on prostitution charges in Dallas. Despite evidence and behavior indicating that she was suffering from a mental illness, she managed to commit suicide in the county jail.

"She was smearing feces on herself, on windows and walls, and told sheriff's deputies that she took medication," Finn said. "She managed to drown herself in a shower."

Finn said this was not an isolated incident. "This happens all the time and it should not," he said.

Others who have investigated jail conditions for the mentally ill say the situation in many places is critical.

"All across the country, this is a huge problem," said Daniel Lewis, a professor of education and social policy at Northwestern University who has studied the plight of the mentally ill in jail. "Once you decide that it is not against the law to be crazy . . . you have to find a way to deal with this."

So critical is the problem in Los Angeles County that one of its seven jails has become solely a mental health treatment center, officials say.

Crimes minor and serious

Lewis said a variety of behaviors bring the mentally ill in contact with police. It could be something as simple as loitering or urinating in public, or shoplifting and writing bad checks, or as serious as rape.

Often the problems begin when people don't get proper medication or fail to take it.

The issue of how to handle mentally ill people in jail came to the fore with the closure of mental institutions three decades ago, Lewis said.

"There were about 500,000 people in those institutions in the 1960s," Lewis said. "There are about 100,000 people in them now. They have to have gone somewhere else."

Still, he said police are getting better at dealing with mentally ill individuals.

"There are good programs out there. Cook County has a good one," he said.

There are few suicides at Cook County Jail, which houses about 11,000 inmates at any given time. In recent years there have been one to three per year.

Leonard Bersky, chief operating officer of the hospital at Cook County Jail, said incoming inmates are carefully screened for signs of mental illness. Inmates who are severely or moderately mentally ill are housed at Cermak Health Services of Cook County, he said.

Carl Alaimo, the chief psychologist at the jail, said about 350 people are processed daily. If serious signs of mental illness are found and if there is any hint that the person might be suicidal, the inmate is carefully observed, he said.

Both men said sheriff's deputies and Chicago police officers get extensive training on dealing with the mentally ill, and officers have wide discretion to divert individuals who are not accused of a serious offense to emergency treatment facilities.

About 5,000 people have been sent to these facilities each year for the past two years, Alaimo said.

Officers' training

Experts say it is crucial for law-enforcement officers to understand how to identify and deal with mentally ill persons.

The police department in Ann Arbor, Mich., was one of the first to provide special training for officers.

Lt. Khurum Sheikh said the crucial first step is training officers on how to detect signs of mental illness and then how to interact with individuals who exhibit the signs.

A special team of trained officers was formed about two years ago.

"If there is an incident with a mentally ill person, a member of this team will be dispatched," Sheikh said.

Most are taken to the University of Michigan Hospital, where they are examined for fitness to stand trial, he said. Most are treated and placed in follow-up programs to ensure that they take their required medicine. The same programs are used when mentally ill people who end up in jail are paroled.

Experts point out that these kinds of systems, although increasing in number, are relatively rare.